Mō ngā tīwiri o te pane me te kaki, he hoahoa tīwiri-rua tōna, arā, ngā tīwiri whakaroa me ngā tīwiri kōpeke. Mā te honohono o ngā tīwiri e rua ka whakapakari ake i te ātete ki te hurihanga o te pane o te huha.
I te wā e whakaurua ana te tīwiri pēhi, ka peia te nekehanga tuaka o te tīwiri whakaroa e te miro ārai i waenganui i te tīwiri pēhi me te tīwiri whakaroa, ā, ka hurihia te ahotea ārai-hurihuri hei pēhitanga rārangi i te pito whati, ā, ka whakanui ake i te kaha ārai-hurihuri o te tīwiri. Ka tapahia te mahi. Ka honoa ngātahitia ngā tīwiri e rua hei karo i te pānga "Z".
Mā te hoahoa o te pito tata o te whao matua, he rite ki te hoahoa o te hononga prosthesis, ka pai ake te hototahi o te tinana o te whao ki te kōhao medullary, ā, ka rite ake ki ngā āhuatanga koiora-ā-tinana o te femur proximal.
Ngā Hipanga Pokanga
TūngaKa taea e te tūroro te whiriwhiri i te tūranga taha, takoto rānei. Me te tūroro i te tūranga takoto, i runga i te tēpu pokanga ira-radius, i te tēpu kukume wheua rānei. Ka nekehia te taha hauora o te tūroro ka mau ki te whāriki, ā, ka nekehia te taha pāngia 10°-15° hei whakahaere i te whakataurite ki te kōhao medullary.
Tautuhinga tika: Tōia te peka e pāngia ana ki te moenga tōia i mua i te mahi, ā, whakatikatikahia te ahunga tōia i raro i te tirotiro fluoroscopy kia paku huri te peka e pāngia ana ki roto, kia paku nekehia hoki. Ka taea te tautuhi anō i te nuinga o ngā whati. He mea tino nui te tautuhi anō i mua i te mahi, ā, ko te kaupapa matua, kaua e tapahia ngāwari mēnā kāore he whakaiti pai. Ka taea e tēnei te penapena i te wā mahi, me te whakaiti i te uauatanga i te wā mahi. Mēnā he uaua te whakaiti, ka taea e koe te tapahi iti i te wā mahi, ā, whakamahia te tokotoko pana, te taputapu whakahoki, te kuku whakaiti, me ētahi atu hei āwhina i te whakaiti. Ngā whati iti Kua wehea ngā taha o roto me waho, ā, kāore he take ki te whakarite tonu. Ka taea te tautuhi anō aunoa i te pito whati ina tīwirihia te tīwiri pēhi i te wā mahi.
Te whakaiti i te trochanter itiKāore e hiahiatia te haere tonu o te cortex medial mō te hoahoa o te whao intramedullary. I te nuinga o te wā, kāore he take ki te whakaiti i te kongakonga whati trochanter iti, nā te mea he iti ake te pānga o te mahi whakaiti kati iti rawa ki te rere o te toto o te pito whati, ā, he ngāwari te whakaora i te whati. Heoi, me whakatika te coxa varus i mua i te whakatakotoranga o te tīwiri, ā, me whakaroa te wā e haere ana ki te whenua me te wā amo taumaha i muri i te pokanga.
Tūnga tapahiKa tapahia he tapahi roa 3-5 cm te roa ki te pito tata o te tihi o te trochanter nui, tata ki te taumata o te tuaiwi iliac o mua o runga. Ka taea te whakatakoto i te waea Kirschner ki te taha o waho o te femur proximal, ā, ka whakatikatikaina kia rite ki te tuaka roa o te femur i raro i te fluoroscopy ringa-C, kia tika ake ai te tūnga o te tapahi.
Whakatauhia te pūwāhi whakauru: kei waenganui paku te pūwāhi tomo ki te tihi o te trochanter nui, e rite ana ki te peka taha 4° o te tuaka roa o te kōhao medullary i te tirohanga o mua. I te tirohanga taha, kei te tuaka roa o te kōhao medullary te pūwāhi tomo whao;
Pūwāhi Whakauru Ngira
IwhakauruGārahiPin Fte tirotiro-ā-roto
R katoaeamed
I te mea he matotoru te pito tata o te whao matua o InterTan, ka taea anake te whakauru i te whao i muri i te riipene katoa i te wā o te mahi. Me whakamutu te riipene tata ina pa te taputapu aukati o te wiri riipene ki te taputapu hongere whakauru. Ko te rahi o te kōhao medullary ka whakatauhia mena ka riipenehia te kakau femur distal. Mena ka kitea e te hihi-X i mua i te mahi he kuiti te kōhao medullary o te kakau femur proximal, me whakarite te riipene rakau femur i mua i te mahi. Mena kaore i te rawaka te riipene, ka uaua te whakauru i te tīwiri. I te wā o te mahi riipene, tera pea ka ru i te awhe iti. Me karohia ngā wāhanga taha o te whao intramedullary, engari me karohia te patuki kaha ki te hiku whao. Ka taea e taua patuki taratara te wehewehe i te wheua i te wā o te mahi, te neke anō rānei i te whati i muri i te whakaiti.
Whakauruhia te ringaringa tiaki kiko ngohengohe, kerihia te taha o te waea ārahi me te wiri, ka whakawhanuihia te awaawa femur proximal mō te whao intramedullary (pikitia i runga ake nei); ki te whaiti te kōhao medullary, whakamahia te wiri ngohengohe kua reamed hei whakawhanui i te kōhao medullary ki te whānui e tika ana; honoa te aratohu whakaurua te whao matua InterTAN ki roto i te kōhao medullary (i raro nei);
PtataLōki
Te whakanoho i te tīwiri whakaroa
Te whakanoho i te tīwiri pēhanga
Whakawetohia te whao maukati tawhiti
RwhakapūmauLōki
Kapu Whakamutunga
Te Maimoatanga i muri i te Tākutatanga
I whakamahia ngā paturopi hei ārai i te mate i roto i ngā haora 48 i muri i te pokanga; i whakamahia te konupūmā heparin taumaha-iti me ngā papu hau hei ārai i te toto totoka o ngā uaua hōhonu (DVT) i ngā pito o raro, ā, i haere tonu te rongoā i ngā mate hauora taketake. I tangohia ngā whakaahua X-ray māmā o te pelvis me ngā whakaahua X-ray anteroposterior me te taha o te hononga hope e pāngia ana hei mārama ki te whakaiti i te whati me te whakapiri ā-roto.
I te rā tuatahi i muri i te pokanga, i akiakihia te tūroro kia mahi i te whakawhāiti isometric o te quadriceps femoris i roto i te tūranga takoto-haurua. I te rā tuarua, i tohutohuhia te tūroro kia noho ki runga i te moenga. I te rā tuatoru, i mahi kaha te tūroro i ngā mahi piko hope me te turi i runga i te moenga. Kāore he pikaunga taumaha i runga i te peka e pāngia ana. Whakatenatenahia ngā tūroro kaha ki te pikaunga i tetahi wāhanga o te taumaha i runga i te peka e pāngia ana i roto i te awhe e taea ana e te 4 wiki i muri i te pokanga. Haere mārire me te hikoi me te pikaunga taumaha e ai ki te aroturuki hihi-X i te 6 ki te 8 wiki. Ngā tūroro kāore e taea te hikoi takitahi me te osteoporosis kino Mō ngā tūroro e tipu tonu ana te wheua i runga i te hihi-X, ka taea e rātou te haere mārire me te pikaunga taumaha i raro i te tautoko.
Tangata Whakapā: Yoyo (Kaiwhakahaere Hua)
WAEA/Whatsapp: +86 15682071283
Wā tuku: Mei-08-2023
